State must strike a balance with new opioid initiative

The following editorial first appeared in the Jefferson City News-Tribune:

Gov. Eric Greitens deserves credit for taking steps to address what is being called an epidemic of opioid abuse in the state.

His latest initiative cracks down on Missouri doctors who over-prescribe the pain medication. Specifically, it targets the estimated 8,000 doctors "whose prescribing habits do not adhere to one or more Quality Indicators pertinent to the use of an opioid."

The Kansas City Star reported they were flagged for not adhering to Centers for Disease Control guidelines that discourage keeping patients on opioids for more than three months, in most cases.

The 8,000 doctors flagged are out of about 19,000 doctors in the state, the Star reported.

The paper said Missouri Medicaid's program, MO HealthNet, covers almost 1 million people. Most of them are low-income children, pregnant women, the elderly and people with disabilities.

While we support the governor's initiative, we have two concerns: It must strike a balance between cracking down on unnecessary opioid prescriptions, while allowing doctors to use their professional discretion to prescribe the medication when necessary.

Flagging 42 percent of the state's doctors seems excessive.

Under new regulations that began last week, MO HealthNet recipients will have to get prior authorization from the state to fill opioid prescriptions past 60 days of use.

The 8,000 doctors will be asked to change the way they prescribe Vicodin and other narcotic painkillers. They'll also be asked to consider referring people on long-term opioids to addiction programs, the Star reported. Those who don't respond after being warned twice could face professional sanctions.

To us, that seems a bit heavy handed, although we recognize the need for action to be taken. Our state remains the only one in the nation not to have a formal prescription drug monitoring program (PDMP).

We hope the state implements the program in a way that addresses the problem with over-prescribing while respecting the professional judgment of physicians.

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.